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Nigeria to integrate ‘Noma prevention’ into primary healthcare service- Adewole

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Babatunde Opalana 

The Minister of Health, Prof. Isaac Adewole on Monday in Abuja disclosed Federal Government’s plan to integrate Noma prevention and control into Primary Healthcare services in the country.

This, he said, will make it imperative for healthcare workers to be the vanguard for the prevention of the spread of Noma by creating awareness on the gravity of the disease because the disease is increasingly alarming, hence the need for urgent actions and a multi-stakeholder approach to stem the tide of its spread.

“Health care workers would be trained on early detection and treatment of early signs of Noma as well as a prompt referral in order to control the progression of the disease before it gets to the stage of disfigurement. I must remind you that Primary Health Centers (PHCs) are the main strategy for achieving ‘’Health for All’’.

“Currently, the Federal Government is revamping and revitalizing 110 Primary Health Centers; one per senatorial zone and health workers in these centres would be trained too on early detection of Noma, nutritional counselling and prompt referral”, he said.

The Minister disclosed that a recent surveillance report from the National Centre for Disease Control (NCDC) reveals that over 25,000 children between the ages of 0 to 59 months were reported to have Noma between 2012 and 2015 in Nigeria with 21,357 cases reported in 2015, adding that the report also shows a spread across all the six geopolitical zones in the country.

Prof. Adewole spoke at the opening ceremony of the maiden edition of the National Noma Day and Stakeholders’ meeting to commemorate the National Noma Day and development of a three-year action plan in Nigeria with the theme “NO NOMA IN Nigeria A MULTI TASK FOR ALL”, held at the Press Centre, Radio House, Abuja.

Noma is a devastating infectious disease that destroys the soft and hard tissues of the oral and Para-oral structures. The resulting dehumanizing oro-facial gangrene may involve the mandible and the nose and may occasionally extend to the infra-orbital margins.

He said the current incidence of Noma in Africa and Nigeria can be attributed to the worsening economic crisis, wars, famine, flood, natural and man-made disasters, deteriorating sanitation, declining nutritional status and the current escalation in the incidence of HIV/AIDS, and increased exposure to infectious diseases that have adversely affected the health and well-being of children.

“Noma has virtually disappeared in the developed countries but it is an escalating public health scourge amongst economically disadvantaged children in the developing world”, he said.

He also said that Federal Government is set to collaborate with the National Orientation Agency to create awareness of the causes, spread, and prevention of Noma using the three major languages in the country.

“The prevention of Noma in Nigeria will require measures that address related problems including poverty, proper hygiene, provision of potable water supply, provision of vaccines against childhood diseases and the need to encourage more mothers to embark on exclusive breastfeeding. It is indeed a task that involves multiple stakeholders. A key step would be the Integration of Noma control into all existing programmes such as malaria programme, Non-communicable disease etc”, he stated further.

Earlier in his welcome address, the Permanent Secretary, Federal Ministry of Health, Mr. Clement Uwaifo said recent research indicates that Noma is almost exclusively found in sub-Saharan Africa and in West Africa along the area running from Senegal across West Africa into Sudan and Ethiopia, coinciding with the so-called ‘‘meningitis belt” which spans from West to East Africa.

Noma, according to him, has high morbidity and mortality rates, so there is the need for a Noma Control Plan with priority given to early detection and immediate treatment.

“Surveillance reports between 2010 and 2017 from the Nigeria Centre for Disease Control has shown an increase in the incidence and prevalence of Noma in different States across the country as a result of poverty, malnutrition and the insurgency in the North East of the country”, he added.

He advocated a concerted effort to mobilize resources to fight noma and implement a policy of common actions to eventually eradicate it in Nigeria.

The Guest Lecturer, Prof Ajike Sunday Olusegun, an Oral & Maxillofacial Surgeon at the Ahmadu Bello Teaching Hospital, Zaria said Noma, otherwise known as Cancrum Oris or Water Cancer is a spontaneous necrosis of the soft and hard tissues of the face, which devours beauty and lives.

According to him, this disease that thrives where there is poverty is a global disease but prevalent in developing countries of Asia and Sub-Sahara Africa among children (80% prevalence) of less than 10 years old.

The risk factors for the disease he said, are poverty, malnutrition, poor hygiene, poor sanitation and living in close proximity to domestic animals.

He said the stakeholders meeting is a step in the right direction towards eradicating the disease in Nigeria.

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